High levels of sugar in the blood can cause damage to nerves. This can affect any nerve in the body but usually affects the longest nerves first. This may result in a gradual loss of feeling in the foot. As your sensitivity to pain is reduced you will become more prone to injury. This information is designed to provide you with a practical guide to keeping your feet healthy. What are appropriate footwear? If possible when buying shoes you should have your feet measured. It may be that because of your sensory loss you are buying shoes that are too small. Your Podiatric or Orthotic clinic can help with sizing if required. You should always wear standard closed in shoes, avoid sandals, open back or slip on styles. The footwear should be the correct length and have adequate depth and width with few internal seams. What else do I need to do? To avoid injury to your feet check inside the shoes before you put them on. Check for any loose objects that may have found their way into your shoes and remove them. How should I use new shoes? Shoes should always be worn in gradually, only wearing them for one hour initially. Build the wear time up one hour per day, increasing to full time wear. After taking your shoes off you should check your feet for any signs of excessive pressure or damage. What if I wear special insoles? If you have been issued with special insoles as part of your condition, it is essential the shoes are not too tight when using them. Try and buy footwear with removable insoles or slightly bigger than you would normally take. Your Orthotist or Podiatrist will be glad to check the fit of shoes and advise you accordingly. Insoles usually reduce the depth of a shoes so do not try to accommodate them in tight fitting shallow shoes. Who is more at risk? • People who do not have feeling in their feet • People who have had diabetes for a long time but have not taken care or had regular check-ups at their surgery • People who have other complications of diabetes such as kidney damage or eye disease • People who have any kind of foot deformities or poor circulation • People who neglect their feet.